A number of news items came out over the weekend saying the public option was being excised from health care reform. This morning the White House is scrambling to reassure people this is not so.

However, the overall message is that while the Obama Administration wants the public option, the President would sign whatever Congress can pass, including a bill that does not include the public option. And there appears to be a strong movement within the Senate to kill the public option. Jacob Hacker explains why that would be more than a damn shame.

The New York Times‘s new pet conservative, Ross Douthat, seems to have noticed one of the massive inconsistencies in the fight from the Right against health care reform: By stoking the fear of senior citizens that their Medicare benefits will be cut, the GOP has placed itself in the role of defender of an entitlement.

Medicare’s price tag, if trends continue, will make a mockery of the idea of limited government. For conservatives, no fiscal cause is more important than curbing this exponential growth. And by fighting health care reform with tactics ripped from Democratic playbooks, and enlisting anxious seniors as foot soldiers, conservatives are setting themselves up to win the battle and lose the longer war.

The fact is, it’s the Right that wants to cut Grandma’s Medicare benefits, not the Left.

We’re already practically a gerontocracy: Americans over 50 cast over 40 percent of the votes in the 2008 elections, and half the votes in the ’06 midterms. As the population ages — by 2030, there will be more Americans over 65 than under 18 — the power of the elderly and nearly elderly may become almost absolute.

In this future, somebody will need to stand for the principle that Medicare can’t pay every bill and bless every procedure. Somebody will need to defend the younger generation’s promise (and its pocketbooks). Somebody will need to say “no” to retirees.

And I have no doubt the Right will do just that, as soon as they defeat health care reform.

It also needs to be said that while Medicare costs are rising, they are not rising nearly as fast as costs in the private health care sector. Inefficiency and excessive costs are only bad when they are found in government. If the private sector is bleeding you dry, you’re supposed to be thankful for capitalism.

Update: Nate Silver counts the Senate votes.

There’s a presentation of What’s Wrong With America in the Los Angeles Times today. There are feature stories on this week’s Remote Area Medical (RAM) health clinic in Inglewood, near Los Angeles, that shine a line on pain and medical neglect. Several of the physicians and dentists who volunteered to work at the one-week RAM fair also volunteer to work in Third World countries. And they said that what they were seeing in Inglewood was just as bad.

Steve Lopez, “At Free Clinic, Scenes From the Third World“:

Stan Brock, who founded RAM in 1985 to bring medical care to Third World countries, told me that in 1992 he began getting requests to do the same work in the United States.

“I don’t have the answers,” said [Dr. Mehrdad] Makhani, the dentist who insisted I look closely at his patient’s ailing mouth. “I’m not a politician. But I have people here with infected teeth, gums, abscesses. I saw a lady bus driver who lost her job and she’s walking around here crying. Her tooth is infected, she’s in pain and she can die from this. This is disastrous. This is a Third World country and people need to come and see this.”

“The people we’re seeing here have teeth as bad as the people in the Upper Amazon,” said Brock, who used to tangle with wild beasts on “Mutual of Omaha’s Wild Kingdom.”

One woman had lived with infected teeth for a year; she had no insurance because she had lost her job. She needed two extractions and a root canal. The dentist who took care of her, Joseph Chamberlain, also had done volunteer work in Brazil.

“They have a nice system of public hospitals and clinics,” he said.

But don’t patients have to wait for treatment?

“Yes,” Chamberlain said. “But not like this. Not for a year.”

I already mentioned the Tzu Chi Foundation, an international Buddhist charity headquartered in Taiwan. Tzu Chi does a lot of medical relief work in impoverished countries around the globe. And now it’s here. I can remember a time when it would have been unthinkable for an Asian charity to come to America to help the poor.

Eugene Taw, an ear, nose and throat specialist with the Buddhist Tzu Chi Free Clinic in Alhambra, was one of many Forum volunteers who has worked in other parts of the world. Yes, he said, there are far too many parallels between the uninsured in the United States and the residents of impoverished Third World nations.

At the Forum, his patients included a diabetic amputee who had not been able to buy his medicine for months, a retiree who couldn’t afford an X-ray for a lung problem, and a 30ish female diabetic with a kidney ailment so serious that Taw called for an ambulance to take her to a hospital.

Kimi Yoshimo, “How L.A.’s massive free clinic event came together“:

It’s pretty profound, the scale of it, the human stories,” Manelli said. “Those things don’t show up on a spreadsheet.”

In all, an estimated $500,000 in care has been provided daily to patients granted appointments on a first-come, first-served basis. Despite the pace, hundreds of uninsured and underinsured people have been turned away. Organizers lament that they could treat more if additional dentists and eye doctors showed up to volunteer in the clinic’s remaining few days.

One woman said she had received an abnormal pap smear result a year ago but was unable to get further medical attention. And then there is “The trumpeter who couldn’t play because he’s missing two teeth. The mother who camped overnight so her daughter could get glasses.” As one of the volunteer doctors said, these things don’t show up in a spreadsheet.

But it gets better. In this same newspaper, in the editorial section, there’s an op ed by Newt Gingrich warning America that if the Democratic plans for health care reform go through, we could have rationing.

Wow. Imagine.

The fear of government rationing is based on the premise that once government has such power, especially the ability to control what is covered by your private insurance policy, it also has the power to deny and restrict.

Those defending the House legislation claim rationing is not in any of its versions, and though that is technically true — no one wants rationing — the unprecedented power this legislation would grant to virtually unaccountable government agencies is all but certain to lead to rationing.

See, in a Free Country, the power to deny and restrict belongs to insurance companies, not the government.

I’ve got more to say, but I have to leave for a bit. I’ll get back to this later.

Brits are becoming increasingly alarmed and astonished at the lies being told about their National Health System. A sampling —

“Americans should put their own health care in order” (Mike Ponton, Wales Online).

“Britons rally to defend their healthcare system” (Henry Chu, Los Angeles Times).

“In the US, my credit card saved my life” (Mitch Glickstein, The Guardian).

[Update: “‘We were duped’: Two British women tricked into becoming stars of campaign to sabotage Obama’s healthcare reforms” (Daily Mail)]

We here are used to it, of course. Nothing positive happens in the U.S. without quickly being smothered by a fog of crazy. But I think the Brits are genuinely shocked. They hadn’t fully appreciated how crazy The Crazy gets here.

I was going to write a longer piece about the fog of crazy, but fortunately Rick Perlstein has a piece in tomorrow’s Washington Post called “In America, Crazy Is a Preexisting Condition” that pretty much says everything I was going to say.

Update: “Healthcare paranoia is part of America’s culture war” (Edward Luce, Financial Times)

One hears over and over that most Americans are happy with their health insurance and the health care they receive. I assume that is true. Righties hold this up as proof that most Americans don’t want to change the system. Polls say that is not true, or at least it wasn’t true before the “death panel” rumors got started. But I want to look at the fallacy behind the assumption that if most Americans are happy the system doesn’t need changing.

Our health care system is something like an old and slowly sinking cruise ship. Passengers on board the ship are having a reasonably enjoyable time. The food and entertainment are pretty good, and everyone still gets clean towels every day. However, in order to keep the ship afloat, from time to time the crew cancels the tickets of a few passengers and tosses them overboard.

At first most of the passengers were not aware this was happening. Or, if it was happening, passengers rationalized that the people tossed overboard must have done something to deserve it. But now enough people have been tossed overboard that most passengers were at least acquainted with one of the tossed, and knew he or she was not a bad person. Further, it is dawning on many that the selection process is random and could fall on anyone at any time, not just those in the cheapest cabins.

Meanwhile, slowly and imperceptibly, the ship continues to sink. The passenger-tossing strategy is just postponing the eventual drowning of everyone on board. So even though the cruise is pretty sweet for those remaining on the ship, there is a growing sentiment that there ought to be another way to keep the ship afloat.

Then the ship’s management announces that maybe there’s another way to keep the ship afloat, but it would require a lot of money to make repairs. Management promises it will only collect money from wealthy first-class passengers and will make up the rest of the difference by budget tightening.

The ship’s passengers divide into two factions. One faction wants to leave well enough alone. They refuse to accept that they might find themselves heaved overboard. They believe the cruise ship company will want more money from all the passengers, not just the wealthy ones, and they don’t see why they should pay more money to fund someone else’s cruise. They also deny that the ship is really sinking, even though all kinds of data have been collected showing that it is.

Passengers in the other faction are not just afraid of being thrown overboard. They also reason that expensive repairs are going to have to be made anyway, because the cruise is not sustainable. If nothing at all is done, eventually the ship will entirely flood with water and disappear into the sea.

The ship also has old and inefficient engines and other systems that make it more expensive to operate than most other cruise ships. If the repairs are done right, the ship could become more cost efficient to operate, and at some point in the future the repairs might actually pay for themselves. However, the longer the repairs are postponed, the more expensive the eventual repairs will be.

The anti-repair faction fights back by spreading rumors that the budget tightening will require passengers to be tossed overboard. The fact that this is happening anyway doesn’t register with these people. Soon they have the whole ship in an uproar, and leaders of the pro-repair faction begin to get death threats and find hate messages spray-painted on their cabin doors.

And there we leave the story, because we don’t yet know how it will turn out.

This is not a perfect analogy. To make it closer to reality we’d have to have vendors who are making a lot of money running the ship as it is begin the rumors to stop the repairs. We’d also have some anti-repair people coming up with nonsensical plans for saving the ship without repairing it. The plans amount to tossing people overboard, but they hide that part of the plan with lots of clever rhetoric.

And, of course, when the ship really sinks those wealthy enough to call for private rescue will transfer to one of the “socialist” ships.

If I had to guess how the story will turn out, it would be that a compromise is reached that amounts to patching the ship with chewing gum and duct tape, and passenger tossing will continue but at a somewhat slower rate for the immediate future. In a few months everyone will realize that nothing was really settled. Both factions will blame the other for the failure to find a solution, and the fight will resume.

Go ahead and discuss, if you are watching. I’ve got the television on, but Miss Lucy wants me to change the litter box first.

Update: I could have done without all the flapping about what a great guy Max Baucus is, but so far the presentation isn’t bad. On to the Q and A.

Why do we need a “uniquely American” health care system? That’s what we have now.

So far he’s not talking about the public option.

Well, it went OK, I thought. Nothing startling.

I just learned that one of the sponsors of this week’s health fair in Los Angeles is the Tzu Chi Foundation, a Buddhist charity headquartered in Taiwan. Tzu Chi was organized by a nun, the Venerable Dharma Master Cheng Yen, and now claims 5 million members in 45 countries.

So I’m saying that if health care reform falls through, there’s a silver lining. As more and more Americans sink into medical destitution for lack of health care, we can round up Tzu Chi, Dharma Drum, and other international Buddhist charities to set up free clinics with a little dharma on the side. Heh.

This is a rumor you are welcome to spread.

Update: Now I’ve learned that Tzu Chi already has a permanent free clinic in Los Angeles. Hey, it’s how the Christian missions got started in Asia and Africa. Why not?

Update: Tzu Chi has already infiltrated Massachusetts. This was low-hanging fruit, of course. Once we have Texas, it’s all over. On to Dallas!

First, the President is speaking in Montana today at another town hall meeting. I understand tickets are being handed out first come, first serve, instead of by the White House, so the audience could be a bit livelier than in the recent New Hampshire event. The meeting is supposed to start at 12:50 local time, which I think would be 2:50 EST. I don’t know if I will live blog — we’ll see — but I will look in on it and comment if anything significant happens.

And I trust the Secret Service will send everyone through five metal detectors and two dozen bag searches before they can be seated.

The New York Times is running a story on the origins of the “death panel” rumors. There isn’t anything in it that you don’t already know, I believe, but the fact that the New York Times is publishing this is itself noteworthy. And the fact that it’s noteworthy when a major newspapers publishes stuff we all already know is itself noteworthy, huh?

Meanwhile, Rudy Giuliani’s descent into political irrelevancy continues as he endorses the death panel rumors.

Scott Lehigh tells us that the anti-health reform mobs are made up of whackjobs. Wow, I wouldn’t have guessed.

Paul Krugman comments on how we are so not post partisan, are we?

There’s just way too much crazy going on for me to deal with. I want to go to a quiet place and play with small, gentle animals.

And you know that in a few months many of the same people screaming about death panels and Marxism will find themselves on the wrong end of a medical bill, or denied care, or lose their insurance, and then they’ll want to know why the government doesn’t do something about it. Well, if they need help, they should go ask Glenn Beck. He’ll be there for them, I’m sure.

The Secret Service has detained a man who was at a townhall meeting yesterday with a sign that said “Death To Obama, Death To Michelle And Her Two Stupid Kids.”

See:

Jonathan Cohn, “The Swiftboating of Health Reform”

Todd Gitlin, “Pre-Existing Conditions“